Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $343.27 / $2,159.00 / $7,095.00	Facility		$343.27	$2,159.00	$7,095.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $218.15 / $286.24 / $398.87	Facility	54	$218.15	$286.24	$398.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.72 / $324.00 / $699.70	Professional		$259.72	$324.00	$699.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $3,373.00 / $4,707.00	Facility		$1,689.00	$3,373.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.64 / $329.23 / $754.33	Professional		$259.64	$329.23	$754.33
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $409.64 / $1,254.00 / $4,050.00	Facility		$409.64	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $409.64 / $409.64 / $447.83	Professional		$409.64	$409.64	$447.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $494.57 / $494.57 / $494.57	Facility		$494.57	$494.57	$494.57
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $346.20 / $346.20 / $346.20	Facility	54	$346.20	$346.20	$346.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $299.68 / $450.91 / $1,108.61	Professional		$299.68	$450.91	$1,108.61
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $346.00 / $786.40	Facility		$250.00	$346.00	$786.40
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $354.29 / $500.57 / $810.07	Professional		$354.29	$500.57	$810.07
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $304.24 / $304.24 / $304.24	Facility		$304.24	$304.24	$304.24
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $240.35 / $240.35 / $240.35	Facility	54	$240.35	$240.35	$240.35
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $258.26 / $388.51 / $685.34	Professional		$258.26	$388.51	$685.34
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $274.13 / $442.62 / $466.70	Facility		$274.13	$442.62	$466.70
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $372.81 / $399.36 / $443.42	Professional		$372.81	$399.36	$443.42
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $494.57 / $555.00 / $597.00	Facility		$494.57	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $346.20 / $346.20 / $346.20	Facility	54	$346.20	$346.20	$346.20
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $301.11 / $460.15 / $1,108.14	Professional		$301.11	$460.15	$1,108.14
United Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,826.00 / $4,851.00	Facility		$964.00	$2,826.00	$4,851.00
United Facility/Professional Professional Modifier Low / Median / High Price $280.58 / $400.25 / $1,003.80	Professional		$280.58	$400.25	$1,003.80
Univera Facility/Professional Facility Modifier Low / Median / High Price $355.73 / $355.73 / $1,158.18	Facility		$355.73	$355.73	$1,158.18
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $240.35 / $281.02 / $281.02	Facility	54	$240.35	$281.02	$281.02
Univera Facility/Professional Professional Modifier Low / Median / High Price $264.19 / $423.99 / $756.26	Professional		$264.19	$423.99	$756.26